YE OLDE MEDICINE SHOPPE
NPI: 1720020324
· PARK RIVER, ND 58270
· Durable Medical Equipment & Medical Supplies
· NPI assigned 06/11/2006
$0.00
Total Medicaid Paid
Provider Details
| Authorized Official | LARSON, LAURIE (PRESDIENT) |
| NPI Enumeration Date | 06/11/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
42 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0011A |
|
21 |
21 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
21 |
21 |
$0.00 |